摘要
目的动态观察骺板损伤后MRI变化过程,探讨MRI临床应用价值。方法以健侧为对照组,32例骨骺损伤病人分别于创伤后1d(25例)、3个月(32例)、6个月(28例)、9个月(26例)、1年(25例)、1.0～2.5年(22例)、2.6～4.0年(10例)行X线检查和MRI平扫,接近闭合期及闭合期形成的骨桥随访至闭合完成。结果MRI较X线更准确地显示了骺板损伤的范围、程度,以及骺板、骨骺和干骺端的解剖学变化,X线未能明确诊断5例。17例发生于胫骨远端的骨桥在1年内被检出,X线未能明确7例,其中6例MRI显示骨桥形成前相关性改变,而X线无特异性发现。1例中央形骨桥3年后出现短缩;7例边缘形骨桥于检出3、6个月后随访显示成角畸形并渐加重,其中4例伴有短缩,3例伴有关节面肥大,2例发现功能障碍,1例行骨桥切除;9例在闭合期形成的骨桥未见明显成角畸形或短缩。结论 MRI可准确显示骨骺损伤,间隔3个月的连续随访可以发现早期骨桥和骨桥形成前相关性改变,预测骨桥的后果及指导治疗。
Objective To dynamically investigate the change process of epiphyseal plate on MRI after injury, and assess its value in clinical application. Methods Thirty-three patients with epiphyseal injury were examined by X-ray and plain MRI 1 day （25 cases）, 3 months （32）, 6 months （28）, 9 months （26）, 1 year （25）, 1.5-2.5 years （22）, 2.6--4.0 years （10） after inju- ry. The patients were followed for the bony-bridge formation form the period nearly closure to complete closure. The uninjured sides served as controls. Results MRI could more accurately display the range and extent of injury of epiphyseal plate, and its anatomic changes, than X-ray. Of which, five were unidentified by X-ray. A formation of bony bridge in the distal tibia in 17 cases was found within one year, of which, seven were unconfirmed by X-ray; six with pre-bone-bridge-formation-related changes were indicated by MRI, but no specificities were noted on X-ray. One with central bone bridge was found shortened three years later. Seven with marginal bone bridge showed angular deformity 3 and 6 months after the detection, and aggravated gradually, of which, four accompanied by shortened, three by hypertrophy of articular surface, two appeared dysfunction, and one underwent surgery for bone-bridge resection; nine with bone bridge formed during closing period were not seen having angular deformity or shortening. Conclusion MRI can accurately display epiphyseal injury, an interval of three-month continuou＇s follow up may find related changes of prophase bone bridge and before its formation, and predict its outcome and guide its management.
出处
《齐鲁医学杂志》
2013年第5期421-424,共4页
Medical Journal of Qilu
关键词
生长面
创伤和损伤
磁共振成像
骨桥
growth plate
wounds and injuries
magnetic resonance imaging
bone bridge
